In July 2022, the United States took a significant step forward in mental health care with the introduction of the 988 Suicide & Crisis Lifeline. Much like dialing 911 for physical emergencies, 988 was designed as an easy-to-remember, nationwide number that connects individuals experiencing mental health crises to trained counselors. However, two years later, mental health professionals are asking a critical question: Is the 988 hotline being underused across the country?

While the infrastructure is in place and the intent is clear, national data reveals uneven usage. Some states are seeing robust engagement with the hotline, while others lag behind. Pennsylvania, for example, was recently ranked 31st nationally for per-capita use of 988. The state saw just 20.9 contacts per 1,000 residents in 2024—raising concerns that millions of Americans may not be aware of or feel comfortable using the service.

The underutilization of the 988 lifeline points to a deeper, systemic issue: people simply don’t know it exists—or don’t trust it yet. Despite being a federal initiative, outreach and education campaigns have been left largely to individual states. That means........

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